The number of women with OUD at labor and delivery quadrupled from 1999-2014

A new CDC analysis reveals that the number of pregnant women with opioid use disorder (OUD) at labor and delivery more than quadrupled from 1999 to 2014.

A new CDC analysis reveals that the number of pregnant women with opioid use disorder (OUD) at labor and delivery more than quadrupled from 1999 to 2014. According to the report, which used data from the Agency for Healthcare Research and Quality's Healthcare Cost and Utilization Project (HCUP), the national prevalence of OUD rose from 1.5 per 1,000 delivery hospitalizations to 6.5 per 1,000 during the study period. Additionally, an analysis of data from the HCUP Inpatient Databases found substantial increases in the 28 states with available data. During the study period, the average annual rate increases were lowest in California and Hawaii and highest in Maine, New Mexico, Vermont, and West Virginia. "Even in states with the smallest annual increases, more and more women are presenting with opioid use disorder at labor and delivery," said Wanda Barfield, MD, MPH, FAAP, Rear Admiral, U.S. Public Health Service, and director, Division of Reproductive Health. "These state-level data can provide a solid foundation for developing and tailoring prevention and treatment efforts." In the state-level analysis, there was wide variation in OUD rates by state. The lowest rates were in Washington, DC (0.7 cases/1,000 hospital births) and Nebraska (1.2), while the highest rates were in West Virginia (32.1) and Vermont (48.6). The report points out that the state variability could reflect differences in opioid prescribing rates or the prevalence of illicit drug use; however, it may also indicate better screening, diagnosis, and treatment of OUD and neonatal abstinence syndrome. Some CDC-recommended strategies for addressing OUD during pregnancy include ensuring appropriate opioid prescribing, maximizing and enhancing prescription drug monitoring programs, implementing universal substance use screening at the first prenatal visit, and ensuring that mothers with OUD receive sufficient patient-centered postpartum care.